CAJ | 학술논문

目的：探讨中青年H型高血压患者血浆同型半胱氨酸（Hcy）与血压变异性（BPV）及炎症介质的相关性。方法选择2013年1月至2014年6月于长沙市第一医院心内科住院诊断为原发性高血压的中青年患者178例，男性119例，女性59例，平均年龄（53.60±6.81）岁。按血浆Hcy浓度分为三组：Hcy＜10μmol/L组52例；Hcy 10～20μmol/L组66例；Hcy≥20μmol/L组60例。采用24 h动态血压监测方法（24 hABPM）测定24 h收缩压标准差（24 hSSD）、白昼收缩压标准差（dSSD）、夜间收缩压标准差（nSSD）等，检测外周血Hcy、高敏C反应蛋白（hs-CRP）、白细胞介素-6（IL-6）、白细胞介素-10（IL-10）浓度和外周血白细胞数（WBC），分析Hcy与BPV、hs-CRP、IL-6、IL-10及WBC的相关性。结果与Hcy＜10μmol/L组相比，Hcy 10～20μmol/L组24 hSSD、dSSD、nSSD、hs-CRP、IL-6、WBC升高，而IL-10降低，差异有统计学意义（P均＜0.05）。与Hcy 10～20μmol/L组相比，Hcy≥20μmol/L组24hSSD、dSSD、nSSD、hs-CRP、IL-6及WBC显著升高，IL-10显著降低，差异有显著统计学意义（P均＜0.01）。H型高血压患者Hcy与24hSSD、dSSD、nSSD、hs-CRP、IL-6及WBC均呈正相关，相关系数分别为0.316、0.297、0.385、0.405、0.324、0.295（P均＜0.05），与IL-10显著负相关（r=-0.302，P＜0.05）。结论中青年H型高血压患者Hcy与血压变异性和炎症因子的变化相关。
목적：탐토중청년H형고혈압환자혈장동형반광안산（Hcy）여혈압변이성（BPV）급염증개질적상관성。방법선택2013년1월지2014년6월우장사시제일의원심내과주원진단위원발성고혈압적중청년환자178례，남성119례，녀성59례，평균년령（53.60±6.81）세。안혈장Hcy농도분위삼조：Hcy＜10μmol/L조52례；Hcy 10～20μmol/L조66례；Hcy≥20μmol/L조60례。채용24 h동태혈압감측방법（24 hABPM）측정24 h수축압표준차（24 hSSD）、백주수축압표준차（dSSD）、야간수축압표준차（nSSD）등，검측외주혈Hcy、고민C반응단백（hs-CRP）、백세포개소-6（IL-6）、백세포개소-10（IL-10）농도화외주혈백세포수（WBC），분석Hcy여BPV、hs-CRP、IL-6、IL-10급WBC적상관성。결과여Hcy＜10μmol/L조상비，Hcy 10～20μmol/L조24 hSSD、dSSD、nSSD、hs-CRP、IL-6、WBC승고，이IL-10강저，차이유통계학의의（P균＜0.05）。여Hcy 10～20μmol/L조상비，Hcy≥20μmol/L조24hSSD、dSSD、nSSD、hs-CRP、IL-6급WBC현저승고，IL-10현저강저，차이유현저통계학의의（P균＜0.01）。H형고혈압환자Hcy여24hSSD、dSSD、nSSD、hs-CRP、IL-6급WBC균정정상관，상관계수분별위0.316、0.297、0.385、0.405、0.324、0.295（P균＜0.05），여IL-10현저부상관（r=-0.302，P＜0.05）。결론중청년H형고혈압환자Hcy여혈압변이성화염증인자적변화상관。
Objective To investigate the correlation among homocysteine (Hcy), blood pressure variability (BPV) and inflammatory media in middle-aged and young patients with H-type hypertension. Methods The middle-aged and young patients (n=178, male 119, female 59 and average age=53.60±6.81) were chosen from Jan. 2013 to June 2014. All patient were divided, according to plasma Hcy concentration, into Hcy<10μmol/L group (group 1, n=52), Hcy 10-20μmol/L group (group 2, n=66) and Hcy≥20μmol/L group (group 3, n=60). The changes of 24-h systolic standard deviation (24hSSD), daytime systolic standard deviation (dSSD) and nighttime systolic standard deviation (nSSD) were detected by using 24-h ambulatory blood pressure monitoring (24hABPM). The levels of peripheral Hcy, high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and interleukin-10 (IL-10), and white blood cell count (WBC) were detected. The correlation among Hcy and BPV, IL-6, IL-10 and WBC was analyzed. Results The levels of 24hSSD, dSSD, nSSD, hs-CRP, IL-6 and WBC increased and IL-10 decreased in group 2 compared with group 1 (all P<0.05). The levels of 24hSSD, SSD, nSSD, hs-CRP, IL-6 and WBC increased significantly and IL-10 decreased significantly in group 3 compared with group 2 (all P<0.01). Hcy was positively correlated to 24hSSD, dSSD, nSSD, hs-CRP, IL-6 and WBC (r=0.316, r=0.297, r=0.385, r=0.405, r=0.324, r=0.295, all P<0.05), and was negatively correlated to IL-10 significantly (r=-0.302, P<0.05). Conclusion Hcy is correlated to the changes of BPV and inflammatory factors in middle-aged and young patients with H-type hypertension.